Document Number:

OCAS-PEP-009 

 

Office of Compensation Analysis and Support 

Effective Date: 

Program Evaluation Plan 12/8/2006 

Revision No. 0 

Evaluation of the Change in Target Organs for Dose 

Reconstruction Involving Lymphoma 

Page 1 of 3 

Author: Signature on File Date: 12/08/2006 Brant Ulsh, Research Health Scientist 

Approval: Signature on File Date: 12/08/2006

Supersedes: 

 J.W. Neton, Associate Director for Science None 

ISSUE 

AUTHORIZATION 

DATE 

EFFECTIVE

DATE 

REV. 

NO. DESCRIPTION 

12/8/2006 12/8/2006 0 This document provides a plan to 

evaluate the change in target organ 

selection for previously completed dose 

reconstruction involving lymphomas. 

1.0 Description

In February, 2006, OCAS determined that the internal and external dosimetry target 

organs used for several forms of lymphoma should be changed. The detailed rationale 

for this decision is described in OCAS-TIB-012. The change resulted from a detailed 

investigation by OCAS of the etiology of lymphoma. 

2.0 Preliminary Issue Evaluation

The issuance of OCAS-TIB-012 changed the internal target organ for most forms of nonHodgkin’s lymphoma and some other forms of lymphoma (primarily in the 200 – 202 ICD 

series) from the highest non-metabolic organ (HNMO) or remainder to the thoracic 

lymph nodes (LN(TH)). The calculated internal doses in these cases are almost 

invariably higher, resulting in a higher probability of causation. 

In addition, the external target organ was changed from bone marrow to various other 

organs (stomach, spleen, thyroid, lung, bladder, etc.), for most forms of lymphoma, as 

described in OCAS-TIB-012. Because the organ-specific dose conversion factors 
Effective Date: 12/08/06 Revision No. 0 Document No. 

OCAS-PEP-009 

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(DCFs) are lower for red bone marrow than for most other organs, this change also 

results in an increase in organ dose, and the resulting probability of causation. 

3.0 Plan for Resolution or Corrective Action

Guidance on target organ selection for lymphoma is given in two documents: (1) OCASTIB-012, and (2) ORAUT-OTIB-005. OCAS-TIB-012 Rev. 0 was issued on August 15, 

2005. Subsequent to issuance of that revision, further changes were made to the 

lymphoma target organs, and these changes were reflected in Rev. 1, issued on 

February 10, 2006. At the same time, ORAUT-OTIB-005 Rev. 2 PC-1 was issued to 

reflect the target organ selection as directed by OCAS-TIB-012 Rev. 1. All lymphoma 

dose reconstructions completed after approximately February 10, 2006 use the current 

target organ selections. 

A query of the NOCTS database was conducted to identify previously completed 

lymphoma claims with a probability of causation <50% which could be affected by this 

change. That query identified 528 such claims, and the ORAU Team is in the process of 

re-evaluating each of them to determine the potential impact on compensability. 

Because the rework of these cases is a time consuming effort, the completion of this 

evaluation is expected to last several months. For those claims where the change in 

target organs has been found to result in an increase in the probability of causation to 

greater than or equal to 50%, NIOSH is returning these claims, as they are identified, to 

the Department of Labor for rework. Upon the completion of the evaluation of all 528 

claims, a program evaluation report will be issued that describes the results of this 

investigation. 

Upon completion of the PER, a notation will be added to the analysis record of each of 

the 528 evaluated claims indicating that the claim has been evaluated and reporting the 

effect, if any, upon PC as a result of the change in target organ. Each notation will 

include the following form, appropriately annotated relevant to the effect on the claim: 

NIOSH has determined that the application of the PER referenced above to this 

dose reconstruction would be to: 

 Increase the probability of causation at the 99th percentile from <50% to ≥50%, 

therefore the claim has been reworked. 

 Increase the probability of causation at the 99th percentile, but the resulting 

probability of causation would still be <50%, therefore no change is warranted at 

this time. Should this dose reconstruction be re-opened in the future, this change 

will be applied. 

 Decrease the probability of causation at the 99th percentile. Since this dose 

reconstruction currently has a probability of causation less than 50%, no change 

is warranted at this time. Should this dose reconstruction be re-opened in the 

future, this change will be applied. 
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4.0 References

1) National Institute for Occupational Safety and Health, Office of Compensation 

Analysis and Support, External Dose Reconstruction Implementation Guideline, 

OCAS-TIB-012, Rev 1, (February, 10, 2006). 

2) ORAU Team, Technical Information Bulletin: IMBA Organ, External Dosimetry 

Organ, and IREP Model Selection by ICD-9 Code, ORAUT-OTIB-0005 Rev 02 

PC-1 (02/10/2006).